BCCA Protocol Summary for Treatment of Advanced Non-Small Cell ...

BCCA Protocol Summary for Treatment of Advanced Non-Small
Cell Lung Cancer (NSCLC) with Vinorelbine in Elderly Patients
Protocol Code:
Tumour Group:
Contact Physician:
LUVIN
Lung
Dr. Christopher Lee
ELIGIBILITY:
• Advanced non-small cell lung cancer
• In elderly patients (> 70 years)
• Any age, unable to tolerate or with a contraindication for cisplatin
EXCLUSIONS:
• More than one previous chemotherapy regimen
TESTS:
• Baseline: CBC & differential, platelets, creatinine, liver function tests, bilirubin
• Before each treatment: CBC and differential, platelets
• If clinically indicated: creatinine, bilirubin prior to each cycle
PREMEDICATIONS:
• See Antiemetic guidelines for non-emetogenic chemotherapy protocols.
Antiemetics are not usually required. Prescribe according to patient specific
symptoms.
• Hydrocortisone 100mg IV prior to vinorelbine if patient experiences pain on
administration
TREATMENT:
Drug Dose BCCA Administration
Guideline
Vinorelbine
30 mg/m 2 /day on days 1 and
8
IV in 50 mL NS over 6-10
minutes
Repeat every 21 days x 6 cycles
B.C. Cancer Agency Protocol Summary LUVIN Page 1 of 1

DOSE MODIFICATIONS:
1. Hematological:
ANC (x 10 9 /L) Platelets (x 10 9 /L) Vinorelbine Dose*
≥ 1.0 and > 100 100%
0.5-1.0 or 75-100 75%
< 0.5 or < 75 Delay
*Consider decreasing vinorelbine to 75% or 22.5mg/m 2 if an episode of
febrile neutropenia occurs with the prior cycle of treatment
2. Hepatic dysfunction:
Bilirubin (µmol/L)
Vinorelbine Dose
≤ 35 100%
36-50 50%
> 50 25%
PRECAUTIONS:
1. Extravasation: Vinorelbine causes pain and tissue necrosis if extravasated. It is
recommended to flush thoroughly with 75-125 mL NS after infusing vinorelbine.
Hydrocortisone 100mg IV prior to vinorelbine may be of benefit. Refer to BCCA
Extravasation Guidelines.
2. Neutropenia: Fever or other evidence of infection must be assessed promptly and
treated aggressively.
Call Dr. Christopher Lee or tumour group delegate @ (604) 877-6000 or 1-800-
663-3333 with any problems or questions regarding this treatment program.
Date activated: 11 Aug 1999
Date revised:
1 Aug 2003 (bilirubin tests)
References:
The Elderly Lung Cancer Vinorelbine Italian Study Group. Effects of vinorelbine on
quality of life and survival of elderly patients with advanced non-small-cell lung
cancer. J Natl Cancer Inst 1999;91:66-72.
B.C. Cancer Agency Protocol Summary LUVIN Page 2 of 2